A Developmental Cascade Model of Maltreatment, Delay Discounting, and Health Behaviors across Adolescence and Young Adulthood

Maltreatment is a pervasive global problem known to have cascading consequences that persist long after exposure subsides (Masten and Cicchetti, 2010). Maltreatment is often co-occurring, involving exposure to multiple types. Cumulative maltreatment, or exposure to multiple types of neglect and abuse, is proposed to be of critical importance for developmental psychopathology. However, a cumulative approach to studying maltreatment provides little insight into the developmental processes whereby it exerts its effects on health. Thus, we employed both a cumulative approach and a multidimensional approach to facilitate our comprehensive understanding of maltreatment experiences related to behavioral development. Given the high prevalence of maltreatment, it is important to cultivate a greater understanding of the processes linking maltreatment and health and to identify developmental periods of vulnerability to its deleterious effects. The present study uses a longitudinal design and a multidimensional approach to examine the effects of maltreatment on delay discounting and health-promoting and health-demoting behaviors during adolescence and across the transition from adolescence to young adulthood. The study sample includes 167 adolescents (aged 13–14 at Time 1; 53% male) who participated across 5 time points over 6 years. At Time 5, adolescents provided retrospective reports of their exposure to maltreatment during adolescence across ages 13–18. Delay discounting, substance use, and body mass index (BMI) were assessed at each time point. We used a developmental cascade model with autoregressive, cross-lagged, and cross-sectional associations to examine the longitudinal multivariate change processes and indirect effects from maltreatment exposure during adolescence to delay discounting and health-promoting and health-demoting behaviors during adolescence and across the transition to young adulthood. Our results indicate that cumulative maltreatment affects health-demoting behavior via its effects on delay discounting and that maltreatment of omission but not commission drives this effect. Furthermore, the findings identify adolescents exposed to maltreatment of omission as being especially vulnerable to marijuana use via elevated delay discounting. Identifying mediating processes linking maltreatment exposure to health-promoting and health-demoting behaviors may be instrumental for preventing deleterious developmental cascades and interrupting related health problems during adolescence and across the transition from adolescence to young adulthood.